Provider Demographics
NPI:1386883734
Name:MAURICE N. UGWUIBE, M.D. P.A.
Entity type:Organization
Organization Name:MAURICE N. UGWUIBE, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:N
Authorized Official - Last Name:UGWUIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-888-4745
Mailing Address - Street 1:1531 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3109
Mailing Address - Country:US
Mailing Address - Phone:361-888-4745
Mailing Address - Fax:361-888-4795
Practice Address - Street 1:1531 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3109
Practice Address - Country:US
Practice Address - Phone:361-888-4745
Practice Address - Fax:361-888-4795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287856301Medicaid